Conducting a gait analysis on patient with multiple lame legs
Have you seen patients come in with more than one lame leg?
Have you seen lameness patterns change depending on where the dog is walking?
In this Learn & Go with Dr. Laurie we meet Tilly, look at cool radiographs on a little known patella luxation surgery technique done by Dr. John Dee himself, that makes it look like part of the tibial crest is gone. We identify a radiographic change commonly seen with stifle stress that you may not be used to looking at. And then we analyze Tilly's gait from multiple angles and on different angled surfaces, visualizing her multiple lamenesses.
Watch the video below to meet Tilly, see the x-rays, and look the multiple gaits that tell us her story.
Tilly has had a partial cut to her tibial crest with a pin creating the perfect wedge to help alleviate her patella luxation.
DOGS CAN HAVE PAIN AND LAMENESS IN MORE THAN ONE LIMB. SOMETIMES ONE LAMENESS HIDES ANOTHER.
Sometimes they injure a second limb trying to shift weight off of a limb that was previously injured, injure it in a separate incident, or be painful from a chronic disease like arthritis.
WHEN A DOG IS SIGNIFICANTLY LAME, THEY WILL USE THEIR HEAD, TO AID IN WEIGHT SHIFTING, TO DECREASE WEIGHT ON THE MOST AFFECTED LIMB.
In the case of a front leg lameness the dog will lift their head, shifting their weight back, when the sore limb starts to bear weight. This is a “Head Bob Up.”
In the case of a rear limb lameness the dog will drop their head down, shifting weight off of a rear limb as it starts to bear weight. This is a “Head Bob Down.”
IF YOU CAN SEE THERE IS A HEAD BOB BUT CAN NOT TELL IF THE DIRECTION IS UP OR DOWN, YOU CAN HAVE THE DOG WALK ON AN INCLINE AND DECLINE SURFACE TO DIFFERENTIATE IT.
When the dog walks uphill, their weight is shifted back to the rear limbs. If the lameness is reduced, it indicates a front leg lameness. If the lameness is exacerbated, it indicates a rear limb lameness.
When the dog walks downhill, their weight is shifted forward to the front limbs. If the lameness is reduced, it indicates a rear limb lameness. If the lameness is exacerbated, it indicates a front limb lameness.
Note that if there are multiple limbs affected, you may see multiple lamenesses. In the Case of Tilly, because her diagonal limbs were both significantly affected, she went back and forth between two significant lameness patterns trying to find a comfortable way to walk and having to alternate lameness patterns because each time she chose one pattern it made the diagonal limb more uncomfortable.